Provider Demographics
NPI:1992517486
Name:GERALD, SHANIYA PRECIOUS
Entity type:Individual
Prefix:
First Name:SHANIYA
Middle Name:PRECIOUS
Last Name:GERALD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 SPRINGBORO LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-4663
Mailing Address - Country:US
Mailing Address - Phone:520-465-8174
Mailing Address - Fax:
Practice Address - Street 1:788 S BS AND K RD
Practice Address - Street 2:
Practice Address - City:GAHANA
Practice Address - State:OH
Practice Address - Zip Code:43021
Practice Address - Country:US
Practice Address - Phone:614-749-3669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-22
Last Update Date:2025-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant